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Evaluating a community-based cervical cancer screening strategy in Western Kenya: a descriptive study
Megan Swanson1, Saduma Ibrahim2, Cinthia Blat3
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of California at San Francisco, Mission Hall, 7th Floor, Room 7444, Box 0132, 550 16th St, San Francisco, CA, 94158, USA. megan.swanson@ucsf.edu.
BMC Women'S Health
|July 5, 2018
Summary
Community health campaigns in Kenya successfully screened women for human papilloma Virus (HPV) using self-collected tests. However, linking HPV-positive women to timely treatment remains a significant challenge for cervical cancer prevention.
Area of Science:
- Public Health
- Oncology
- Infectious Diseases
Background:
- Kenya faces one of the world's highest cervical cancer incidence rates.
- Limited access to screening exacerbates the high burden of cervical cancer among Kenyan women.
- Self-collected human papilloma Virus (HPV) testing during community health campaigns offers a potential solution to expand screening access in rural areas.
Purpose of the Study:
- To assess the feasibility and effectiveness of community health campaigns in delivering HPV screening for cervical cancer prevention in rural Kenya.
- To evaluate the uptake of self-collected HPV testing and the subsequent linkage to treatment among HPV-positive women.
Main Methods:
- A four-day community health campaign (CHC) was conducted in Migori County, Kenya, involving community enumeration, outreach, and mobilization.
- Participants underwent self-administered HPV screening, with samples tested for HPV DNA.
- Results were communicated via SMS, phone call, home visit, or clinic visit, with HPV-positive women referred for cryotherapy in a screen-and-treat strategy.
Main Results:
- Out of 255 women who enrolled, 19% tested positive for HPV, with younger age being a significant predictor.
- Over three-quarters of participants received their results, but only half of those who tested HPV-positive presented for treatment.
- Younger age was the only significant predictor of HPV positivity, with each additional year of age decreasing the odds of a positive test by approximately 4%.
Conclusions:
- Community health campaigns can successfully deliver HPV screening to a significant proportion of eligible women in rural settings.
- While a majority of women received their HPV test results, a substantial gap exists in timely presentation for treatment among HPV-positive individuals.
- Improving linkage to care and treatment is crucial to effectively reduce the burden of cervical cancer in high-incidence regions like Kenya.
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